AB0260 DISABILITY IN PATIENTS WITH RHEUMATOID ARTHRITIS: RELATIONSHIP WITH ALEXITHYMIA.
Authors: Y. Shalkovskyi, Y. Shkarivskyi, M. Stanislavchuk
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Rheumatoid arthritis (RA) is the chronic, destructive, immune-mediated inflammatory process that has a gradient course and causes disability of approximately 50% over the next 5 years of the disease. Acute pain syndrome, which is accompanied by RA, often leads to a violation of the psycho-emotional sphere with manifestations in the form of depression, anxiety and alexithymia. Alexithymia defined as a personal emotional disorder that characterized by difficulty in identifying and describing subjective feelings. As there are insufficient data on disability in patients with RA in combination with alexithymia, we screened patients with RA, investigated the level of disability and found a connection with alexithymia. <h3>Objectives</h3> To investigate the level of disability in patients with rheumatoid arthritis and clarify a probable connection with alexithymia. <h3>Methods</h3> RA patients diagnosed according to the ACR/EULAR 2010 classification criteria (Daniel Aletaha et al., 2010). The presence of alexithymia was determined by TAS-20 – «Toronto Alexithymia Scale» questionnaire (Graeme J. Taylor, D. Ryan, R. Michael Bagby, 1994). Disability was determined by a questionnaire DRI - «The Disability Rating Index» (Bo A. Salen, Erik V. Spangfort, Ake L. Nygren and Rolf Nordemar, 1994).<sup>[1]</sup> RA activity was assessed with the Disease Activity Score (DAS28), Simplified disease activity index (SDAI), Clinical disease activity index (CDAI), functional status with the Health Assessment Questionnaire (HAQ), pain intensity was determined by the Visual Analogue Scale (VAS). Statistical analyses were performed using IBM Statistics SPSS 20. Results are presented as mean with standard deviation (M ± SD). <h3>Results</h3> The study included 146 patients with RA (90.7% of women). The average age of the patients was 50.1 ± 12 years, and the duration of the disease ranged from 1 to 21 years (7.4 ± 4.7). Among 146 examined, alexithymia (TAS-20 ≥ 61) was detected in 36 people (24.7%). All patients had different level of disability detected by the DRI questionnaire, with scores ranging from 5.4 to 79.8; and the average value was - 31.1 ± 17.1. In patients without alexithymia, the disability was 26.8 ± 14.8, in patients with alexithymia – 44.5 ± 16.8. Functional ability in individuals with RA without alexithymia according to the HAQ was 0.9 ± 0.6, in contrast to the group of patients with RA and alexithymia - 1.7 ± 0.6. The significance of the differences between groups depending on the presence of alexithymia according to functional ability and intensity of pain was at the level of p &lt; 0.05; and disability - at the level of p &lt; 0.01. A direct strong correlation was established between alexithymia and disability, functional ability and VAS: DRI (r = 0.514; p &lt; 0.01); HAQ (r = 0.450; p &lt; 0.01); VAS (r = 0.457; p &lt; 0.01). We found that the presence of alexithymia in patients with RA was associated with an increased risk of functional disability. Odds ratios are used to identify the risk of functional disorders in patients with alexithymia. RA patients with TAS-20 score ≥ 61 had an odds ratio of 7.57 [95% CI: 2.13 – 26.98] (p &lt; 0.002) for moderate functional disability and 21.47 [95% CI: 4.82 – 95.61] (p &lt; 0.0001) for severe functional disability by HAQ, and 14.98 [95% CI: 4.48 – 50.13] (p &lt; 0.0001) by DRI. <h3>Conclusion</h3> The alexithymia in patients with rheumatoid arthritis is associated with a bigger disability, as well as with impaired functional ability and severity of pain syndrome. We concluded that alexithymia may be consider as a risk factor of the disability in patients with RA. <h3>Reference</h3> [1] Salén, B. A., Spangfort, E. V., Nygren, A. L., &amp; Nordemar, R. (1994). The Disability Rating Index: an instrument for the assessment of disability in clinical settings. <i>Journal of clinical epidemiology</i>, <i>47</i>(12), 1423–1435. https://doi.org/10.1016/0895-4356(94)90086-8 <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.